The taboo against masturbation and the malign influence of the foreskin

To this period [childhood] belongs also a very important point in regard to physical education—the guarding against onanism …. one of the most certain and most terrible of those means which shorten and derange life …. I am fully convinced that the vice is exceedingly common, and highly destructive of human nature …. The grand object is to prevent onanism altogether.

Dr Christoph Hufeland, 1828 (39)

… the prepuce seems to exercise a malign influence in the most distant and apparently unconnected manner; where, like some of the evil genii or sprites in the Arabian tales, it can reach from afar the object of its malignity, striking him down unawares in the most unaccountable manner; making him a victim to all manner of ills, sufferings and tribulations; unfitting him for marriage or the cares of business; making him miserable and an object of continual scolding and punishment in childhood, through its worriments and nocturnal enuresis; later on, beginning to affect him with all kinds of physical distortions and ailments, nocturnal pollutions, and other conditions calculated to weaken him physically, mentally, and morally; to land him, perchance, in jail or even in a lunatic asylum.

Dr P.C. Remondino, 1891 (40)

The masturbation phobia

As in Britain and the US, the universal phobia against masturbation was the main driving force behind the introduction of widespread circumcision in Australia at the turn of the century. David Walker has examined the fears surrounding seminal loss and their connection with conceptions of manhood and national development in three important articles (41) which are essential for understanding this topic, but there are several areas in which his studies can be amplified and modified. As Walker points out, nineteenth century medical orthodoxy held that any seminal loss weakened the system, but that masturbation was especially dangerous, partly because it was so easy to do and partly because it was indulged in mainly by the young, who needed all their energies for proper growth and development. (42) For all the fervour with which colonial medical and moral texts catalogued the evils which arose from masturbation, they largely repeated the wisdom received from Britain (and to a lesser, though increasing, extent the US); there were few original antipodean contributions to this field of medical science. In concentrating on irregular medical practitioners who offered various quack cures for seminal loss and other "private diseases, however, Walker could leave the impression that concern with masturbation was a fringe preoccupation and that mainstream doctors (those trained in medical schools and usually members of the British Medical Association) were less worried by the problem. This is misleading: the danger of masturbation was a sacred orthodoxy of the regular medical profession, and the quacks were only trying to take advantage of the fears already generated by its own advice and propaganda. Nor is it possible to draw a hard and fast line between the regular doctors and the quacks; the former exhibited plenty of evidence of ignorant faddism and eccentricity, while the latter frequently offered more humane and less damaging treatments. Ineffective they might have been, but when you are dealing with imaginary diseases it is to the advantage of the patient if the cure is not too heroic. I shall deal with each of these points in turn.

It is only in recent times that masturbation has ceased to be regarded as a serious disease likely to have frightful consequences for those who indulge in it. As late as 1966 the Principal of Grimwade House, Max Haysom, told his charge of 13-year old boys at the annual sex education lecture that masturbation was wrong for three reasons: from a religious point of view, it was a sin against purity; from a social point of view it was selfish because only a man’s wife had the right to the products of his penis; and from a medical point of view it would cause blindness if persisted in. The principal added ominously that there had been trouble with this sort of thing among the boarders, though he did not explain how it had been dealt with—presumably not by circumcision, as in most cases that had already been seen to. (43) Even today, when every variety of sexual expression is discussed on television and most may be viewed on video, the topic of masturbation—"the earliest, most intimate and perhaps the most common of all sexual behaviours, as Bennett and Rosario observe—still arouses anxious titters. (44) If Haysom represented enlightened establishment opinion in the 1960s, it is apparent that the taboo against masturbation must be very deeply ingrained.

Indeed, in 1860 the Australian Medical Journal reported the case of a seaman, a "finely made Irish boy, aet. 17, who actually killed himself through masturbation. He was admitted to hospital on 8 May with "slight febrile symptoms and treated for fever, but his condition steadily deteriorated and additional symptoms appeared, necessitating examination of the lower part of the body:

attention being directed to the genital organs, the penis was found to be larger than natural; the glans red and inflamed, and a slight swollen condition of the prepuce. On examining his shirt the lower part was found stiffened with some albuminous fluid, much resembling that produced by the seminal vesicles. The testicles were found atrophied to about the size of a kidney bean, soft and painless to moderate pressure. On being questioned as to his habits he denied having made any improper use of himself, or being addicted to masturbation. A friend of his ... said the young man was much given to solitude and ... thought he was addicted to this bad habit when in his berth. He was again interrogated as to the escape of this albuminous fluid and admitted that some did escape after passing stool. He was warned as to consequences but persisted in denying the existence of masturbation.

As soon as the possibility of masturbation arises, the boy ceases to be regarded as a patient in need of care and becomes a malefactor who must be interrogated until he confesses his crimes. On 1 June the patient was described as having "filthy habits, pretending to be unable to get up and too lazy to use the spittoon. The next day delirium was reported, and his condition worsened steadily until the 6th, when he died. A post-mortem revealed "miliary tubercles throughout both lungs, but also a contracted bladder, enlarged vas deferens and seminal vesicle, and "congestion of the spinal cord. With tell-tale signs like these the conclusion was inescapable: "a case of masturbation, producing excessive spinal irritation, debility and, indirectly, death. (45) Whatever the poor boy was suffering from, it is remarkable how quickly the doctors turned their attention to his genitals and sought the culprit in his adolescent sex drive. Most likely he was dying of tuberculosis.

James Beaney

The most voluble, if not the most influential, medical writer on masturbation for the next thirty years was Dr James Beaney. He is chiefly remembered today for a scandal relating to abortion and his arguments with fellow doctors, but he deserves to be better known as the most important Australian populariser of the new medical orthodoxy on spermatorrhoea. James George Beaney (1828–1891) was born in Kent, took a medical degree at Edinburgh and became an army surgeon. He settled in Melbourne in 1857 and established himself as a prominent member of the medical profession there. (46) He published prolifically, but the main works in which in sought to bring the latest the understanding of sexual function and dysfunction to his colonial audience were Spermatorrhoea in its physiological, medical and legal aspects (1870) (47) and The generative system and its functions in health and disease (1872). (48) As he explained in the preface to the first of these, his books were "intended to exercise the same influence in these colonies which the works [of Lallemand, Acton and Courtenay] exercise in Europe, by spreading correct information amongst our populations (1870, p. x). In these texts, addressed to an educated public as much as to his professional colleagues, Beaney earnestly hammered Acton’s main themes: masculinity was an embattled condition; spermatorrhoea was the signature disease of the day and the most deadly single threat to men’s health; semen was more precious than blood; masturbation infallibly caused a raft of serious illnesses; children were a contradictory mixture of innocence and vice; treatments for spermatorrhoea could be effective; but only if victims avoided the quacks and took their problems to genuine professionals. I will consider each of these points in turn.

Like Acton, Beaney saw men as beset by sexual threats: desire nagged constantly, but to yield was to risk debility, disease and ultimately madness. He sought to elucidate "the many sources of danger which threaten the integrity of their manhood (1872, p. 12) and to acquaint young men with "the dangers connected with the abuse of the sexual functions (1870, p. 45). The most serious of these was spermatorrhoea, defined as "an abnormal emission of the seminal fluid:

Of all the diseases to which man is liable, there are few which induce so much … mental anxiety as this. It embitters all the victim’s social relations and subjects him to the harrowing reflection that he is the object of the taunts and jeers of those about him (1870, p. 45).

Masturbation was both a specific form of spermatorrhoea and frequently also the cause. Beaney asserts that "the chief cause of this undue discharge of semen without the intention of the patient is abuse and explains that single men "ruin the nervous equilibrium of their sexual system and find themselves "at the mercy of the least excitement. Like Acton, Beaney warns that any discharge of semen is risky: even marriage, with its opportunities for legitimate intercourse, can be a trap. A married man "may so abuse the advantages which unlimited congress gives him, as also to enervate himself and subject himself to involuntary losses (1872, p. 183).

Because of the importance of semen to the health of the male organism, such losses lead inevitably to illness. Beaney observes that philosophers "in all ages have held that "excessive coit. depressed the nervous system and that there was "a close connection between the brain and the seminal fluid (1872, p. 17). He considers it to be "the most important secretion of the body … which taxes the fountain of life more than any other (1870, p. 10) and quotes Swedenborg’s view that one drachm was the equivalent of an ounce of blood; "squandering such a fluid inevitably undermined "the stability of the corporeal system (1872, p. 27).

It followed that masturbation must be harmful. Beaney defines "this wretched habit as "the production of emission of seminal fluid by friction and manipulation of the virile organ; or any process which produces a flow of that important secretion which is not the natural excitement of sexual intercourse with the opposite sex. Sounding more like a tub-thumping prophet than a man of science, he goes onto denounce masturbation as "one of the most pernicious habits that can possibly be indulged in, sapping … the strength both of mind and body, reducing the most vigorous intellect to the feebleness of old age, and the most athletic frame to a condition of helplessness (1870, p. 56). In accordance with the nerve force theory of disease, he asserts that masturbation directly caused a range of disorders by disturbing the equilibrium of the nervous system:

This excessive withdrawal of semen … involves the necessity of concentrated vital energy upon the function of seminal secretion, hence, more of this valuable fluid—the mainstay of the system—is drawn from the blood than the body can bear without derangement of other functions (1872, p. 182).

Among the immediate consequence are a fairly contradictory bundle of symptoms, including inflammation of the urethra, irritation of the bladder, disturbed sleep, erotic dreams and nocturnal emissions, confusion of mind, vertigo, wakefulness, depression and languor (1870, pp. 61–3). In the long term, the practice could lead to epilepsy, phthisis (tuberculosis), insanity and impotence (1870, p. 78). On account of the "great expenditure of nervous force during unnatural excitation, masturbation was particularly implicated in the genesis of epilepsy, and Beaney found confirmation of the connection in the confession of many epileptics that they had practised that habit when young (1870, pp. 63–5; 1872, p. 201). Doctors thus had a duty to make every effort to minimise seminal loss, and that meant discouraging masturbation. Children should be watched closely for signs of the vice and action taken to nip it in the bud. Although he writes approvingly of circumcision as a hygienic measure, Beaney does not link it directly with the prevention of masturbation and largely repeats Acton’s prescription of parental vigilance, moral exhortation, exercise and purity. He quotes the celebrated Dr Christoph Hufeland, who held that one of the "grand objects of such training was to "prevent onanism altogether, but he had little but old remedies to offer at this stage (1872, pp. 222–6).

The most important of these was still willpower. In advocating the necessity of restraint in sexual matters, Beaney follows Acton in pathologising the normal male sexual response and exemplifies the way in which doctors were replacing priests as the watchdogs of sexual morals. He refers to men being "troubled with morbid erections and their sleep interrupted with lascivious dreams (1872, p. 233) and claims that symptoms of spermatorrhoea include "too frequent and troublesome erections at night, with erotic dreams and emissions (1872, p. 192). That many men of that period did find erections troublesome shows how effective the doctors had been in convincing the public that normal sexuality was really a disease. Beaney sounds like St Augustine, deploring his own erections as punishments sent by god to remind him of original sin, or perhaps the Council of Trent, which believed that, before the Fall, Adam’s erections were voluntary—paradise indeed, for both those who wanted fewer and those who wanted more. On the issue of moral guidance, Beaney takes the Christian view that the flesh is a snare set by the devil for the ruin of the soul, but he suggests that scientific knowledge was a better basis for behaviour than theological sanction: the need for restraint was shown by the terrible consequences of indulgence. Man’s mental endowment, he writes,

has rendered it unnecessary to place physical barriers to the copulative function, as it gives to man a more noble means of restraint by … the knowledge of cause and effect. The reasoning faculty is intended to teach him the consequences of acts that do violence to his physical system (1870, p. 30).

Sin will undoubtedly be punished, but in this world rather than the next. Because it was impossible to establish "a code of laws to prevent sexual excess, it was "the duty of medical men to point out the ill-consequences … and endeavour … to modify the evil (1872, p. 32). The appeal might be to reason, but the atmosphere is that of a confessional: the relationship between a masturbator or other victim of spermatorrhoea and his doctor is much as the same as that between a sinner and his priest:

It is generally difficult to obtain from the sufferer a frank confession of the cause of which he is himself the author. … shame prevents an honest … disclosure in many cases. The medical man … having first gained the confidence of the patient, will generally succeed in eliciting the truth. It is always desirable that the patient should fully admit the practice … the fact of having "made a clean breast of it gives them an access of moral courage which is very useful … in facilitating their cure (1872, p. 187).

Elsewhere he writes that doctors should "assist the feeble victims of sexual excesses by their counsel and personal influence (1870, Preface), just like a pastor with a straying sheep. Beaney is in favour of sex education, but on the assumption that it was largely a matter of teaching boys not to have sex (1870, p. 41).

The sexual nature of children was another issue on which Beaney followed Acton closely. He shared the latter’s opinion that "there should be perfect quiescence of the sexual function until … maturity (1870, p. 38), but also his uneasy awareness that there usually was not. On the one hand, "as a rule the child is … entirely free from any knowledge of the sexual functions, or indeed of the existence of any sensation of pleasure in connection with them (1872, p. 102); and yet, "I have met with hundreds of quite young children [with] … the most complete theoretical knowledge of the character and purpose of their sexual construction. What was worse, these children have been caught "teaching others to play with their genitals (1872, p. 103). Anomalies abound: "There will … under judicious care and education, be no tendency on the part of young children to notice sexual impressions; yet, "there are well-authenticated cases in which … abnormal activity occurs, and the child exhibits a surprising tendency to sexual indulgence (1872, p. 5). Beaney did not expect sexual feelings to occur before puberty, yet "at a very early period of childhood some children are very prone to handle their privates, and the habit, if unchecked, becomes permanent and injurious (1872, pp. 6, 106–7). It almost makes one giddy to watch Beaney contradicting himself from one sentence to the next as he dodges and weaves from the empirically normal to the morally normative: ultimately it becomes apparent that the innocence of childhood is not a natural condition, but a social desideratum which must be imposed by force:

That blissful period of innocence which intervenes between the birth and the advent of puberty should command the solicitude oft the parent; for it is during that interesting transition, that the foundation of lasting mischief is laid by those whose minds have already been contaminated by evil associations. The vigilance of parents and school proprietors cannot be too constantly exercised, in order that … thoughts and impressions of a sexual nature may be prevented (1872, pp. 5–6).

Bad practices like masturbation "must be stamped out if the children are to grow up in that virgin purity which we all expect in those of tender years (1872, p. 119). Beaney repeatedly expresses surprise at how early this vice seems to manifest itself, necessitating "the vigilance of parents to interdict any approach to the indulgence. He warns particularly against public schools, "where boys induct each other into many improper practices and adds a long quote from Acton on the problem (1870, p. 57).

Although Beaney is largely recycling the new orthodoxy on spermatorrhoea advanced by Acton et al, he does make some adaptations for his Australian audience. His main point is that is that the relatively free and easy life of the Antipodes, the more relaxed social structure and the more intimate mingling of the sexes lead to increasing sexual precocity among children, thus magnifying the threat of spermatorrhoea to colonial manhood (1872, pp. 104–5). He fears that the "softening and purifying influence of home life is not so strong as in England and that the rough manners and lowly origin of the servant class are a constant source of dangerous knowledge and mischievous practice, and he returns repeatedly to the "evil influence of servants … in teaching young children to handle their genitals and thus to fall into the habit of masturbation (1872, pp. 6, 114–23). This was a problem that also exercised Acton, but it was more severe in a new country which lacked the social checks and balances of the old.

In treating cases of seminal loss and problems arising from masturbation Beaney did not rely solely on moral exhortation, but there was not much in his battery of prescriptions which distinguished him from the quacks he so routinely denounced. The most common treatments involved sitz baths, "generous diets, different kinds of alcohol and various chemical compounds, particularly potassium bromide and phosphorous (the latter believed to be an important constituent of the brain), and the application of electricity to the nervous system—"galvanism and "Faradization in Beaney’s terminology, though it is not clear how the two procedures differed from each other (1872, pp. 160, 164–5, 202–5). Treatment for a man suffering from impotence induced by masturbation included sea baths, a ban on smoking, galvanism and doses of phosphoric acid, quinine, iron and strychnine (1872, p. 164–5). A case of epilepsy caused by masturbation was cured by a program consisting of dry sherry, phosphorous, strychnine, iron, Faradization and sleeping on a hard mattress (1872, p. 205). Unlike Acton, Beaney did not recommend cauterisation of the urethra in cases of spermatorrhoea, but his favoured treatments for prostatorrhoea (emission of prostatic fluid) tended to be more severe than those recommended for loss of semen. In addition to the nostrums above, these might include the porte-caustique, leeches, blistering of the perineum, a No. 12 galvanic sound and injections of belladonna and camphor into the urethra (1872, p. 237). If such a preposterous mixture of poisons and placebos had any curative effect it could only confirm the imaginary status of the diseases being treated.

Beaney is not yet thinking of circumcision as a treatment for spermatorrhoea, but he is moving in that direction. He notes, without going into details, that "hypersensibility of the glans penis and the urethra will often be found to be at the bottom of the troubles, and he cites a case reported in the Lancet (1867) on the connection between a tight foreskin and epilepsy. This article claimed that "a variety of cerebral symptoms … such as pain in the head, giddiness, noises in the ears, eructations etc … may be entirely removed by circumcision, though it conceded that circumcision of several mental patients did not reduce the incidence of their epileptic fits (1872, p. 113). In accordance with the nerve force theory, Beaney is naturally alert to the phenomenon of "sympathetic irritation (1872, p. 107) and notes that a "very important cause of "morbid sensitiveness in the penis is the extreme length of the prepuce; this was not only a "source of irritation in childhood but "an embarrassment at puberty (1872, p. 109). Beaney does see the foreskin as a source of dangerous irritation and is attracted to circumcision as a remedy, but, like Acton, he is pessimistic about the chances of the procedure winning wide acceptance because of its religious connotations. He urges that the "secretions which accumulate beneath the foreskin should not be left "as a source of mischief and quotes Acton on the complicity of the foreskin in sexual precocity (1872, p. 109). He then comments that circumcision should be more widely practised and regrets that its sacred associations (Jewish and Islamic) discourage its wider adoption:

It is well known that in surgery we are often obliged to do for Christian men that which is to some extent analogous to circumcision … and the operation is sought for much more frequently than formerly on purely hygienic grounds. It is to be regretted that so valuable a preventive against many sexual disabilities should have been environed by sacerdotalism (1872, p. 111).

Medical science had learned that circumcision could prevent or cure a raft of sexual problems; only irrational prejudice (or "maudlin sentiment) held up its general application. In his book on children’s health (1873) Beaney does not mention circumcision (or any sexual issues) at all, but there is a passage in his Disorders of the generative system which suggests that he might have been eyeing the operation as a possible treatment for masturbation. When children are caught handling their genitals, he writes, the parent must "confront the evil in the child and take all the necessary steps, both surgical, hygienic and admonitory, to overcome the cause of the bad habit (1872, p. 113). There is no elaboration of what surgical steps he has in mind, but one wonders.

The malign influence of the foreskin

It was possibly in the next decade that doctors in Australia made the link between the "irritability of the foreskin and the aetiology of spermatorrhoea and drew the obvious conclusion that the surgical removal of the offending tissue would offer the prospect of both prevention and cure. In a paper on the need for sexual restraint published in 1884, Dr J.W. Springthorpe considered the "problem of the sexual appetite before marriage and observed that it could be dealt with in three ways: masturbation; resort to prostitutes; and restraint. He echoed Beaney in his depiction of the threat posed by seminal loss "in a young colony and the equal danger of leaving treatment of such complaints to the quacks:

Upon a subject of such importance, and one too frequently neglected or relegated to the nefarious hands of quackery, it is imperative that … physicians … should have fairly comprehensive knowledge and definite views. And in a young colony like ours—one legacy of whose fevered past has been a distinct neurotic tendency, with climatic influences that favour early bodily development, and where the newspapers, by their almost daily tales of sexual crimes, point conclusively to the existence of an extremely grave state of affairs.

Self-evidently, both masturbation and resort to prostitutes were too dangerous to contemplate, leaving abstinence before marriage as the only safe way to meet the sexual appetite. By their surgical skill, doctors could assist young men (and even young women if necessary) to restrain themselves:

Hence onwards until marriage the excito-motor mechanism should be the subject of investigation and regulation, so that none but the normal impressions might travel upwards to the brain. To this end it might be necessary to snip off a redundant prepuce, divide a contracted meatus, clip a short frenum … and the same, mutatis mutandis, in the female.

In the discussion which followed there was no dissent from this proposition, and a Dr McMillan affirmed that "absolute sexual continence was compatible with perfect health and opined that "the instinct of abstinence ought to be encouraged. (51) It is interesting to note Springthorpe’s assertion of the medical profession’s claim to investigate and regulate the normal functioning of the body.

Despite Koch, Pasteur and the discovery of germs, medical opinion in these areas did not change much over the next generation: as late as 1913 the Melbourne Pediatric Society considered the case of a 13-year old boy who complained of tiredness and pain in the back of his thighs. Dr Alan Mackay suggested "the trouble was quite possibly due to masturbation in a boy of that age, and he thought the boy should be watched. He had often noted the association of nasal catarrh, dilated pupils and bad teeth with sexual aberrations. (52) With such salutary examples as these in the professional literature, who could doubt that masturbation would inevitably lead to bodily and mental weakness, insanity and death?

Certainly not the authors of manuals on child rearing, who were quick to warn parents of the need to guard against the development of evil habits in their children. In Mother and child (1913) M. Danvers Power devotes the whole of a chapter called "Teaching children the natural laws of sex to this single problem. Quite little children, she or he writes, "often form the bad habit of playing ... with the sexual organ, finding that it produces a pleasant sensation. Power considered him/herself a progressive who believed in telling children the truth about sexual functions, and the truth was that bad sexual habits had terrible consequences:

The children become disobedient, rebellious against authority, cross and irritable. Next, the effect upon the nervous system is very serious. The pleasant feeling which is experienced at the beginning, ends in a spasm of the nerves, which leaves the body absolutely wasted of all nerve force, drained of all nervous energy, exhausted as is the body of a person who has had a fit. And while the nerves and character are being ruined the mind is also suffering. The memory becomes dull, the child cannot grasp his lessons, and goes down to the bottom of the class. ... Where the body is not naturally strong, a general wasting may be followed by consumption, or life may be ended by some other terrible disease. ... And if continued, not only the body and character are ruined, but the mind collapses also, and madness is the result.

Note the persistence of the nerve force theory of disease and how widely diffused it has become. Mothers should therefore teach their children that their sexual organs should be used only after they marry, and then only for the purpose of creating their own babies and that if they use them "before that time, or injure them by bad habits, illness and misery and probably madness will be the result. (53) Curiously enough, a Frederick Danvers Power became a leading figure in the boy scouts and prepared the first edition of the Australian Boy Scouts Handbook in 1922. You may recall the tenth law—"A scout is clean in thought, word and deed—and you would be right in thinking that this meant no playing with yourself or your mates. Unclean thoughts

may be in connection with the abuse of the private parts of your body. ... Thee parts have been given to you for a special purpose, and God will reward or punish you accordingly as you take care of or abuse them. They should never be handled except to clean them. (54)

Both the views and the fluffy toy language are so close to those expressed in Mother and child that it is hard to believe they are not by the same person; perhaps Frederick was the husband or son of M. In warning against the dangers of self-abuse Power was following the example of Baden-Powell himself, who had included a section on continence in the appendix to Scouting for boys (1908) and a further caution in Rovering to success (1922). This included the immortal advice to "keep the organ clean and bathed in cold water every day, a suggestion which soon acquired a ribald notoriety. (55)

Of undoubted progressive sympathies was the better known Marion Piddington, an exponent of sex education for the young and a supporter of both birth control and eugenics. She was no more relaxed about masturbation than Power or anybody in the medical profession: it was a harmful habit that tended "to arouse the sexual nature prematurely and could lead to interest in prostitutes, with the attendant danger of venereal disease, as well as eugenically inadvisable marriages. Piddington was definite that the habit of self-abuse should be prevented though non-specific as to the best methods; she did, however, suggest that boys should be clothed in trousers without pockets. (56) Such examples tend to confirm Neuman’s conclusion that the main aims of the early sex educators were to warn children and adolescents about the impropriety of sexual exploration before marriage and to discourage autonomous activity on their part. (57)

Quackery and orthodoxy

The views of the quacks were little different from those of the mainstream medical profession, though they did tend to be cast in more lurid language. Two of Sydney’s most prominent specialists in the "nervous and private diseases of males, Drs Freeman and Wallace, referred to masturbation as a "pernicious habit which caused a whole brood of diseases, a "disgusting subject, a practice alarmingly widespread among the young, and a problem which must be overcome; their own cures (not detailed in the publicity) were always efficacious in this respect. (58) Even more colourful language was employed by another practitioner, Dr W.B. Towle, who mixed moral and scientific condemnation in a manner typical of the period:

The general effects of seminal weakness, nocturnal and diurnal emissions, impotence and sterility, caused by self-abuse in early life, or excessive indulgence in later years, if not relieved by appropriate and thorough treatment, are most deplorable. This malady is one of the most widespread and destructive experienced by man. Few, except physicians, have any conception of the prevalence of self-abuse, or of its disastrous effects on both mind and body. This habit, according to the experience of the most renowned medical men, degrades man, poisons the happiness of his best days and ravages society. It is certainly one of the most ruinous vices ever practised by fallen man. Its victims are found among the young of both sexes in every country .... Many who really perish from its effects are supposed to die from other causes, such as consumption, epilepsy, heart diseases, exhaustion and failure of the vital powers. It ultimately destroys the mind as well as the body. In its milder form it produces loss of memory, melancholy, depression of spirits, timidity and loss of energy. In its worst form idiocy and insanity. Many maniacs owe their loss of reason to no other cause. In the tabulated reports of every lunatic asylum are a great number of cases in which the cause of insanity is set down as "masturbation. (59)

Given their generally more hellish scenarios, you might think that the quacks would be more enthusiastic about the heroic approach to male sexual problems, and masturbation specifically, than the regular doctors. In fact, the reverse is true: it was the mainstream professionals who favoured modern scientific methods of treatment, such as mechanical restraint, infibulation of the foreskin, cauterisation of the urethra and circumcision. The remedies proposed by the quacks were altogether gentler and less punitive. Freeman and Wallace did not recommend circumcision for any genital complaint and discouraged it even in cases of phimosis: "Slitting the foreskin or circumcision is frequently adopted by some surgeons, but we never resort to such measures unless ... absolutely necessary. (60) They made their own attack on quacks who offered fake cures, especially cauterising the urethra with caustic substances, a treatment recommended by Acton and widely practised by orthodox professionals. (61) Freeman and Wallace were vague about their own methods, but not Dr Towle: he specialised in electro-therapy, offering a range of electrical appliances designed to cure female complaints, liver and kidney problems, joint disease, nervous debility and impotence. The "Hercules Life Renewer could even treat self-abuse successfully, though in cases where spermatorrhoea was also present, supplementary remedies would be required. (62) There is not a word here about surgical intervention. Indeed, if published testimonials from successfully treated patients may be believed, there is evidence that some men resorted to quacks precisely to avoid the surgical remedies proposed by regular physicians. Towle quotes the example of a young man suffering from paraphimosis:

A surgeon had told him he would have to undergo an operation; that the prepuce would have to be cut through. Shrinking from this prospect he decided to consult me. I administered at one some medicine, the effect of which was to relax the constricted muscles ... [and] the patient awoke to find himself quite well. He wrote saying: "I am doubly grateful to you for having not only cured me so easily, but for having saved me from having to undergo a surgical operation, which would have been very painful, and would have left its mark upon me all my days. (63)

Given this sort of resistance to the operation, it is not surprising that the circumcision lobby targeted its propaganda at parents rather than the actual subjects of the procedure and that it became common only because it was done without the consent of the patient; wherever circumcision has become general it has been an operation that authority (usually parental) has inflicted on the young or otherwise powerless, rarely a procedure that competent males have elected for themselves.

For all the embarrassment they caused the regulars, it is thus not so easy to draw a firm line between the quacks and the medical profession proper. The practitioner who diagnosed a case of tinnitus as stemming from masturbation and who treated it by means of electric shocks and a long course of urethral dilation with catheters was not a quack, but Dr W.F. Quaife BA, MB etc, who described his cure in the journal of the Australian branch of the British Medical Association. (64) Indeed, the campaign against quackery was part of a wider effort on the part of doctors to establish their own professional standing and assert a monopoly over the management of bodily (and some mental) functions.

The mainstream doctors had been vying with the irregular practitioners since at least the 1860s, and the main issue on which the struggle was fought was their competence to provide better treatment for "nervous and private diseases. Acton had taken numerous swipes at the quacks, and another significant writer on spermatorrhoea, F.B. Courtenay, had actually put together a broadside called Revelations of quacks and quackery (1860s) in which he emerged as a crusader against the irregulars, and particularly against their claims to cure spermatorrhoeic and related diseases. In his own work on that subject he expressed the usual views on masturbation but was fairly relaxed about involuntary nocturnal emissions and critical of the cauterisation treatment advocated by Acton and others. He attacked the quacks and deplored the reluctance of the medical profession to take spermatorrhoea seriously, thus driving men into their hands. (65) As we have seen, he was one of the influential English writers whose ideas Dr Beaney had sought to popularise in Australia.

Beaney’s Spermatorrhoea was explicitly part of a campaign to wrest the treatment of these diseases away from the quacks and vest it with qualified doctors; as he writes in the Preface, it was "designed to lead those who are afflicted by them to abandon the pretentious quacks and turn to "legitimate and honourable practitioners like himself. (66) Like Courtenay, he is critical of his profession for its "culpable neglect of one of the most important and serious … diseases to which mankind is subject, thereby driving "a large section of the community … into the hands of the vilest imposters (1870, Preface). By refusing to take the disease seriously and treat it like any other medical complaint, the profession was in fact responsible for sending "thousands of wretched sufferers … into imbecility and the madhouse and even the grave. Rejecting the prudish and old fashioned view that medical science was too delicate to be concerned with the genitals, Beaney asserts its claim to management of the whole body: "Are not the functions of the surgeon … to embrace all the maladies to which the body is liable?, including those afflicting the genital organs (1870, p. viii). His audience here is twofold: he wants to convince the public that victims of spermatorrhoea should seek the help of professionals like him, not patronise the irregulars; but he also wants to persuade his conservative colleagues that they should accept spermatorrhoea as a real and serious disease which demanded their professional attention. Quoting from Copland’s Medical dictionary and other English authorities, Beaney regrets that too few doctors took the problem seriously, thus relinquishing it to the "unqualified empiric. He is pleased to note, however, that this state of affairs is changing and that doctors are making amends for their neglect "by the ardour with which they are investigating [the problem] and the earnestness with which they endeavour to protect the public against the frauds of those quacks who have so long preyed upon them (1870, p. 48). The nub of the case was that spermatorrhoea was too grave and complex a disease to be treated by anybody except the experts:

These several phases of spermatorrhoea require special treatment and suggest the folly of trusting their management to the pretentious charlatans and ignorant quacks who parade their nostrums in the daily journals. The disorder … is too serious in its character and consequences to be carelessly dealt with. … the question … calls forth the highest faculties of the surgeon or physician, and taxes the powers of his art often to their limit (1870, p. 103).

Yet the sad fact is that there was very little even the most conscientious physician could do about these diseases that would distinguish them sharply from the quacks they so bitterly despised. As we have seen, their treatments for various forms of spermatorrhoea consisted largely of bathing, exercise, diets and "medicines like potassium, phosphorous and strychnine; their rivals offered much the same regimen, including the application of electricity. Beaney derided them for making use of an "Electro-Galvanic Vital restorer, apparently forgetting that he himself was an exponent of galvanism and Faradization. (67) There was not much in any of this to grab the attention of the public and persuade it to abandon the irregulars; something dramatic was needed, something that only the medical profession proper could offer, some sort of magic bullet.

Professionalisation of medicine

The years 1881–1914 were a crucial period in the emergence of the modern medical profession in Australia. A five-year degree had been introduced at Melbourne University in the 1860s, and Sydney followed suit in 1883; the New South Wales branch of the British Medical Association was established in 1881. The emergence of the profession was largely a process of differentiation; as Lewis and Macleod (68) have shown, doctors were struggling on two fronts: against chemists, druggists and "quacks for control over health care; and against the friendly societies over conditions of work and fees. Doctors had been trying since the 1860s to get legislation which would define and secure their position. Their efforts were opposed as an attempt to gain sectional privilege and knocked back several times, but in 1900 the NSW parliament passed the Medical Practitioners Act, which made it an offence for anybody without recognised qualifications to use a medical title and empowered the Medical Board to debar practitioners on a range of grounds. This victory recognised the new prestige of scientific medicine: "the orthodox practitioners finally won legislative endorsement because they had established a cultural authority superior to that accorded ‘alternative’ practitioners, (69) though it might be more precise to say that this legislative sanction created the very categories of "orthodox and "alternative: before then it had been pretty much a free-for-all. Apart from beating the quacks in the lobbying game, however, it is hard to see what medical achievements underlay the doctors’ triumph, though the promise of the new germ theory of disease may have been part of it: in 1899 the Sydney Morning Herald looked forward to the conquest of cancer and even gout. (70) As the example of Herbert Moran makes clear, however, the moral and even confessional role of the doctor increased along with the growth of his scientific status, (71) and the new scientific spirit did not lead to any immediate questioning of the links which had been drawn between masturbation, immorality and disease.

The case of Dr Richard Arthur (1865–1932) is instructive. Born in England and educated in Scotland, he settled in Sydney in 1891 and became director of a number of major city hospitals. He lived and practised in Mosman and was an independent member of the NSW state parliament for various north shore electorates from 1904 to 1932 and briefly Minister for Health in the Bavin government in 1927. (72) He inveighed against the deceitful machinations of the quacks, yet he was himself a fervent purity campaigner who wrote numerous pamphlets for the Australasian White Cross League on the necessity of youthful continence; he was a keen practitioner of hypnotism and an advocate of vegetarian diets; he warned boys against the dangers of self-abuse and advised parents to circumcise their sons as a preventive measure. It was only the last point which distinguished him from Freeman et al. Arthur agreed with the quacks that masturbation led to severe physical and mental illness:

The seed is a very valuable substance, and if it is drained away continually, all the strength and vigour leave the body. The boy or man who practises this vice becomes stunted in growth and enfeebled in mind. he becomes unfit for games and athletics of any kind, and he is not able to study or devote his attention to any object. ... He may so lower his health that he falls an easy victim to that terrible malady, consumption, or he becomes subject to epileptic fits, or, worst of all, he may so injure his brain that he develops insanity in one or other of its dreadful forms. (73)

He did not mention circumcision in pamphlets directed at boys, but in one addressed to adults he advised parents to watch carefully for signs of self-abuse and to consult a doctor immediately if a child displayed "any tendency to objectionable habits. In accordance with the medical wisdom of the day, he added that "this vice in the young is sometimes brought about by the existence of some local irritation ... [and] the operation of circumcision is needed. (74)

Arthur was a leading light in the Australasian White Cross League, itself an affiliate of the English organisation of the same name and a direct descendant of the groups that waged the English purity campaign of the 1880s which, among other achievements, pressured parliament to raise the age of consent, restrict the circulation of pornography, ban nude bathing and criminalise homosexual activity among males. (75) In this capacity Arthur urged moral purity in the young and the strict avoidance of sexual activity before marriage. It was this obsession which led him into disagreement with the quacks, whom he criticised for scaring boys with the claim that even involuntary seminal emissions (such as wet dreams) were harmful and in need of special treatment. He reassured them that "in most cases this emission is not unnatural. It is merely a sort of overflow of the semen, and if it do not occur oftener than once in ten days or a fortnight, there need be no cause for anxiety. If, however, they are frequent or are followed by "languor and depression, the sufferer should "seek the advice of some respectable doctor, who will probably soon cure the condition. (76) Arthur’s qualified and reluctant acceptance of nocturnal emissions was a consequence of his insistence on chastity; if adolescents and young men renounced masturbation and sexual intercourse, their pent-up energies would have to find release somewhere, and wet dreams were less harmful than "artificial stimulation. Arthur appears to have held a pretty low estimate of the average adolescent sex drive: to the modern mind, a teenager needing no more sex than one wet dream a fortnight would be a sorry specimen indeed. (77)

In summary, then, it was not the quacks like Freeman and Towle who offered circumcision as a cure for masturbation and other male complaints. They offered the medical stock-in-trade of Dr Beaney and his colleagues from the previous generation —bathing regimes, proprietary medicines, electrical devices, special diets etc—but were reluctant to perform surgical procedures and were losing the right to perform them. It was the university-trained and properly accredited medical practitioners who urged circumcision and other surgical interventions as effective, scientific treatments which embodied the latest advances in modern medical understanding and which they alone could provide, in opposition to and in competition with the fringe practitioners. Some patients might have resorted to quacks expressly to avoid the harsh remedies proposed by the regular physicians. In this context it is possible to see the doctor’s campaign against quackery as part of a battle for professional turf, indeed, as part of the struggle to establish their own professional identity, and the circumcision cure as one of the weapons in their armoury.

Quackery is a matter of perspective, and today it is the crusaders against masturbation and the advocates of circumcision who look like quacks, an impression that some of them seem only too eager to foster. Consider these examples. During a lengthy controversy on the practice in the correspondence columns of the British Medical Journal in 1935, Dr R.W. Cockshut wrote that

all male children should be circumcised. This is "against nature, but that is exactly the reason why it should be done. Nature intends that the adolescent male shall copulate as often and as promiscuously as possible, and to that end covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin. Thus the adolescent has his attention drawn to his penis much less often. I am convinced that masturbation is much less common in the circumcised. (78)

Following the decision of the Australian Paediatric Association to recommend against routine infant circumcision in 1971, a doctor in Perth, G. Hall, boasting that he had performed some 2,000 infant circumcisions with bone forceps, recorded the following objection:

I am convinced that when God made his covenant with Abraham and ordered this peculiar and embarrassing mark of identification of His chosen people, he regarded it as a health law as well as a ceremonial act. I am equally convinced that that unnatural edict by the APA is Satanic in origin. The only part of the body which has ever been ordered by our Creator to be surgically removed is the male foreskin. (79)

Such comments emphasise the point that the moral pressure towards circumcision has always been much stronger than any scientific demonstration of its therapeutic advantages: if it really did offer health benefits great enough to outweigh the injury, it would not be necessary to do it without the consent of the subject.

The demonisation of the foreskin

With the rise of the masturbation phobia came the demonisation of the foreskin. It ceased to be a normal part of the male body and came to be regarded as an inherently unhealthy structure that gave nothing but trouble. By the 1930s Moran could unthinkingly refer to (healthy) foreskins in the same breath as infected appendixes and diseased gall bladders; medically they were all in the same category. (80) Acton’s views were developed further in the US by Lewis Sayre and his disciples from 1870, (81) and popularised in Australia by George Beaney. A later formulation of them was by the US physician George Beard, an edition of whose home medical guide was published in Sydney in 1884. Walker reports that the reception Beard’s writings is difficult to gauge, but that James Smith, one of the most prolific men of letters in late nineteenth century Victoria, was enthusiastic about his work and drew on it for his own essays and lectures, including one on the nervous system delivered in 1881. (82) As you might expect, Beard devotes a good deal of space to "nervous diseases of modern times, including neurasthenia, seminal emissions, impotence, noises in the ear, self-abuse and "sexual exhaustion, (83) and it is in this context that he focuses on the foreskin. He notes that early masturbation is nearly always present in cases of sexual exhaustion and reports that in two thirds of nervous disease cases "there is more or less abnormal condition of the prepuce. The reason is obvious: "In a nervous person a redundant, elongated prepuce, covering the gland [sic] and pressuring upon it, acts as an irritant to the whole system, and excites any number of nervous symptoms, even to melancholia and paralysis. In such cases circumcision is needed to relieve the pressure on the glans, and such operations "have been known to radically cure cases of nervous disease. (84)

These views are in accordance with the nerve force theory of disease and are no more far-fetched than what Lewis Sayre, Joseph Howe (85) and their followers had claimed, but Geo. Talbot Woolley was not afraid to go further. He was honorary surgeon at Castlemaine Hospital, Victoria, and in a paper given to the Intercolonial Medical Congress in 1889 he detailed the symptoms of tight foreskins on infants in terms that suggested he was well versed in modern medical orthodoxy. The child, he asserted, has

a peevish or peaky look; the skin has a shiny, dry, cracked look about it, and there are generally some sores about the nostrils and corners of the mouth, which are quite typical and different from the common herpes .... [He] is generally ill, feverish, with bad appetite and furred tongue, and passes urine very frequently; which is sometimes thick and milky, and sometimes of a very high colour; he is generally in pain about the lower part of his abdomen, but is not able to give you any definite account of his condition.

Woolley remarked that most medical men, on being told that an infant is fretful and feverish, will suggest there is something wrong with his diet, but he asserts that if you inquire more closely

you will often find that the child often wets his napkin almost incessantly, that his penis is almost perpetually in a state of erection, and that ... the prepuce is so tight that it is impossible to see the lips of the meatus, which ... will be found to be in a state of congestion.

The secretions generated under the foreskin accumulate and gradually this material "buries itself in the surface of the glans penis, or the under-surface of the prepuce, and sets up a definite form of constitutional disturbance. This will eventually express itself in the symptoms of a wide range of diseases, including hernia, worms, consumption of the bowels, typhoid, bloody urine, inflammation of the brain, bowels and lungs, and even paralysis of the legs. Woolley claimed that he had been able to cure all these symptoms in boys ranging in age from 20 months to eight years by the simple expedient of separating the foreskin from the glans and cleaning out the sebaceous matter. (86) What was really happening here we shall never know, but it is likely that Woolley was observing what Sayre and others had taught him to expect. (87)